11 Oct
|
ProjectTree
|
Ahmedabad
11 Oct
ProjectTree
Ahmedabad
Ahmedabad
On-site
5+ years
Night Shift (US hours)
No. of Openings: 2
About The Role
Project Tree is starting a back-office service for clinics and doctors in the USA. Working from the Ahmedabad office, this role combines patient support over the phone with end-to-end medical billing for US clinics. The key mission is to code and submit claims correctly so that the clinic receives its insurance payment.
Key Responsibilities
- Call Handling &
- Patient Service
- Answer inbound calls from US patients, clinics and doctors professionally and resolve their queries on billing, claims and insurance.
- Record every call and its outcome in Dr Pro.
- Book patient appointments with doctors and specialists.
- Follow up with patients, clinics and insurance companies on pending matters.
- Insurance Verification &
- Authorization
- Verify patient insurance eligibility and coverage over the phone.
- Obtain prior authorization from insurance companies before treatment, where required.
- Medical Billing &
- Coding
- Pre-claim: review the doctor's documentation and assign the correct billing codes.
- Generate the bill and submit the claim with billing codes to the insurance company.
- Ensure claims are clean and error-free to avoid denials and delays.
- Post-claim: track claim status, handle denials or rejections, correct and resubmit, and ensure the insurance payment is received.
- Post received payments and reconcile them against claims.
- Escalate unresolved cases to the reporting manager on time.
- Documentation &
- Compliance
- Maintain complete and accurate records of calls, claims and payments in Dr Pro.
- Keep all patient information strictly confidential as per US HIPAA rules and company policy.
- Meet daily targets for calls, claims and accuracy; share daily work reports.
Requirements
- Experience: Minimum 5 years in US medical billing / US healthcare back office (RCM).
- English: Good spoken and written English is mandatory, with clear telephone communication.
- Medical Knowledge: Sound knowledge of medical terminology, CPT/ICD-10 coding and US insurance (Medicare, Medicaid, commercial payers).
- Shift: Must be willing to work a fixed night shift (mandatory).
- Computer: Good typing speed; comfortable with software applications, MS Excel and email.
- Education: Graduate in any stream (Life Sciences, Pharmacy, Nursing or B.Com preferred).
- Advantage: Medical coding certification (CPC / CCS) or experience on medical billing software.
Key Skills
- Customer service and active listening
- Attention to detail and accuracy in coding
- Strong follow-up and problem-solving
- Ability to learn current software quickly
What We Offer
- Salary: No bar for the right candidate.
- Training on Dr Pro application and processes.
- Opportunity to grow with a new service line from the start.
📌 Healthcare Back Office Executive (Ahmedabad)
🏢 ProjectTree
📍 Ahmedabad